Institutional members access full text with Ovid®

Share this article on:

Delirium in critically ill patients: Impact on long-term health-related quality of life and cognitive functioning*

van den Boogaard, Mark RN, MSc; Schoonhoven, Lisette RN, PhD; Evers, Andrea W.M. PhD; van der Hoeven, Johannes G. MD, PhD; van Achterberg, Theo RN, PhD; Pickkers, Peter MD, PhD

doi: 10.1097/CCM.0b013e31822e9fc9
Clinical Investigations

Objective: To examine the impact of delirium during intensive care unit stay on long-term health-related quality of life and cognitive function in intensive care unit survivors.

Design: Prospective 18-month follow-up study.

Setting: Four intensive care units of a university hospital.

Patients: A median of 18 months after intensive care discharge, questionnaires were sent to 1,292 intensive care survivors with (n = 272) and without (n = 1020) delirium during their intensive care stay.

Measurements and Main Results: The Short Form-36v1, checklist individual strength-fatigue, and cognitive failure questionnaire were used. Covariance analysis was performed to adjust for relevant covariates. Of the 915 responders, 171 patients were delirious during their intensive care stay (median age 65 [interquartile range 58–85], Acute Physiology and Chronic Health Evaluation II score 17 [interquartile range 14–20]), and 745 patients were not (median age 65 [interquartile range 57–72], Acute Physiology and Chronic Health Evaluation II score 13 [interquartile range 10–16]). After adjusting for covariates, no differences were found between delirium and nondelirium survivors on the Short Form-36 and checklist individual strength-fatigue. However, survivors who had suffered from delirium reported that they made significantly more social blunders, and their total cognitive failure questionnaire score was significantly higher, compared to survivors who had not been delirious. Survivors of a hypoactive delirium subtype performed significantly better on the domain mental health than mixed and hyperactive delirium patients. Duration of delirium was significantly correlated to problems with memory and names.

Conclusions: Intensive care survivors with delirium during their intensive care unit stay had a similar adjusted health-related quality of life evaluation, but significantly more cognitive problems than those who did not suffer from delirium, even after adjusting for relevant covariates. In addition, the duration of delirium was related to long-term cognitive problems.

From the Department of Intensive Care Medicine (MvdB, JGvdH, PP), Scientific Institute for Quality of Healthcare (LS, TvA), Department of Medical Psychology (AWE), and Nijmegen Institute for Infection, Inflammation and Immunity (N4i) (JGvdH, PP), Radboud University Nijmegen Medical Centre, The Netherlands.

* See also p. 319.

Mr. van den Boogaard carried out the study, the statistics and drafted the manuscript. Ms. Schoonhoven and Dr. Pickkers were involved in the design, supervised the study and helped to draft the manuscript. Drs. Evers, van der Hoeven, and van Achterberg supervised the study and corrected the manuscript. All authors read and approved the final manuscript.

The authors have not disclosed any potential conflicts of interest.

For information regarding this article, E-mail:

© 2012 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins